Perception of the quality of care, work environment and sleep characteristics of nurses working in the National Health System

Emergency nursing staff's well-being, burnout, and sleep on 12-hour shifts

OBJECTIVE

To know job satisfaction, work-family balance, sleep quality, and burnout in nursing staff after the introduction of the 12-h rotating shift in the emergency department of a tertiary hospital.

METHOD

Cross-sectional observational design carried out in February 2023 for the first collection (T1) and October 2023 for the second collection (T2) in emergency nursing staff. Sociodemographic data, work and family reconciliation, job satisfaction, degree of burnout, and sleep quality were collected.

RESULTS

In T1, 66.7% (74) of professionals answered, with an average age of 44.72 years (SD:10.60). 50% were on a 12-h shift. In T2, 91.9% (102) of professionals answered, with an average age of 44.75 years (SD11.07). 54.9% were on a 12-h shift. 71.2% in T1 and 66.7% in T2 were somewhat or very satisfied with the flexibility of their work schedules. 8.9% in T1 and 10.3% had a high overall burnout. In T1, the average global PSQI score was 7.66 (SD:3.82) and in T2 it was 8.46 (SD:4.05). Significant differences were found in terms of work and family reconciliation between the different rotating shifts analyzed (P<.05), and not significant for the rest of the variables.

CONCLUSIONS

Emergency nursing staff prefer 12-h shifts as they facilitate work-family reconciliation and do not negatively affect sleep, burnout, or job satisfaction.

Relation between Burnout and Sleep Problems in Nurses: A Systematic Review with Meta-Analysis

Burnout can affect nurses’ sleep quality. The aim of this study was to analyze the relationship between burnout syndrome and sleep problems in nurses. A systematic review with meta-analysis was performed. PubMed, CINAHL and Scopus databases were used. Some of the inclusion criteria were quantitative studies, in which the levels of burnout and sleep disorders were investigated in a sample of nurses using validated scales. A total of 12 studies were included. Sociodemographic variables did not influence the relation between burnout and sleep problems, except for being female. The environment and workplace violence, together with psychological traits and shifts, affect the probability of developing burnout and insomnia. The meta-analysis sample was n = 1127 nurses. The effect size of the correlation between burnout and sleep disorders was r = 0.39 (95% CI 0.29−0.48) with p < 0.001, indicating that the higher the level of burnout in nurses, the greater the presence of sleep disorders. The positive correlation between burnout and sleep disorders is a problem that must be addressed to improve the health of nurses. Developing turnicity strategies, using warmer lights in hospital units during night shifts and eliminating the fixed night shift could improve nurses’ working conditions.

Do Polish Nurses Have a Problem with Sleepiness during the Epidemiological Threat of the SARS-CoV-2 Virus?

Nurses may experience cumulative sleep deprivation in the current epidemiological situation, which is the COVID-19 disease. Lack of rest leads to decreased concentration. The research topic is important for improving patient safety in hospitals. Assessment and analysis of the level of sleepiness of nurses after 3 consecutive night shifts and its impact on functioning in social life. The study adopted the diagnostic survey method, which was conducted using a survey technique. The questionnaire consisted of 3 parts: personal particulars, the survey and the Karolinska Sleepiness Scale (KSS) version A. After the research, 164 correctly completed questionnaires were obtained. The level of somnolence in individual measurements after a night shift significantly increased among the nurses examined (P < .0001). Respondents who felt a higher level of drowsiness after a night shift thought that their work definitely influenced contact with their friends or family and had difficulty in performing household duties. There is no statistically significant relationship between the level of sleepiness and sociodemographic factors. After each night shift, the level of drowsiness in nurses increases. This may result in reduced alertness and attention levels on subsequent working days. Shift work has negative consequences in the form of depleted personal life. Further research into the effects of insufficient sleep among nurses should be conducted. This may be necessary for patient safety in healthcare centers. The awareness on the subject of healthy sleep among shift nurses should be raised. It is advisable to conduct research in order to assess the effectiveness of various therapies in dealing with sleep disorders among shift nurses. The interventions taken should be adapted to the current epidemiological situation, which is the COVID-19 disease.

Undergraduate nurses' perception of the nursing practice environment in university hospitals: A cross-sectional survey

OBJECTIVE

To describe the psychometric properties of the Practice Environment Scale of the Nursing Work Index (PES-NW) among undergraduate nurses and to compare their perceptions of the nursing practice environment by academic year and unit type.

BACKGROUND

Despite the fact that nursing students develop most of their undergraduate learning and training in the nursing practice environment, their perception about it has not been considered to date.

METHODS

The psychometric properties were analysed on a sample of 180 undergraduate nurses. Data collection was carried out in 2018. Data were analysed using percentages, frequencies, mean, standard deviation and Mann-Whitney U test. Factor structure was evaluated with exploratory factor analysis, and reliability was evaluated with Cronbach's alpha.

RESULTS

Psychometric analysis showed an adequate construct validity and reliability for the PES-NWI. Cronbach's Alpha was 0.884. Undergraduate nurses perceived most hospitals as favourable, scoring the 'Nurse-physician relationships' factor highest and 'Staffing and resource adequacy' factor lowest.

CONCLUSION

The PES-NWI is a valid and reliable instrument that could be applied in future research to explore nursing students' perceptions of the nursing practice environment.

IMPLICATIONS FOR NURSING MANAGEMENT

Nurse managers are responsible for supervising and ensuring that the nursing practice environment at university hospitals meets the necessary criteria to support the workplace learning of undergraduate nurses.

Nurses' protocol-based care decision-making: a multiple case study

AIM

To describe and explain nurses' protocol-based care decision-making.

BACKGROUND

Protocol-based care is a strategy to reduce variability in clinical practice. There are no studies looking at protocol-based care decision-making. Understand this process is key to successful implementation.

METHOD

A multiple embedded case study was carried out. Nurses' protocol-based care decision-making was studied in three inpatient wards (medical, surgical and medical-surgical) of a university hospital in northern Spain. Data collection was performed between 2015 and 2016 including documentary analysis, non-participant observations, participant observations and interviews. Analysis of quantitative data involved descriptive statistics and qualitative data was submitted to Burnard's method of content analysis (1996). The data integration comprised the integration of the data set of each case separately and the integration of the findings resulting from the comparison of the cases. The following the thread method of data integration was used for this purpose. The SRQR guideline was used for reporting.

RESULTS

The multiple embedded case study revealed protocol-based care decision-making as a linear and variable process that depends on the context and consists of multiple interrelated elements, among which the risk perception is foremost.

CONCLUSION

This study has allowed progress in protocol-based care decision-making characterisation. This knowledge is crucial to support the design of educational and management strategies aimed at implementing protocol-based care.

RELEVANCE TO CLINICAL PRACTICE

Strategies to promote protocol-based care should address the contexts of practice and the ability of professionals' to accurately assess the degree of risk of clinical activity. Hence, it will promote quality of care, patient safety and efficiency in healthcare cost.